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Fernandes, Silke; Sicuri, Elisa; Kayentao, Kassoum; Eijk, Anna Maria van; Hill, Jenny; Webster, Jayne; Were, Vincent; Akazili, James; Madanitsa, Mwayi; Ter Kuile, Feiko O.; Hanson, Kara (2015)
Publisher: Elsevier
Languages: English
Types: Article
Subjects: Àfrica subsahariana, Malària, Pregnancy, Preventive medicine, wa_110, wa_30, wa_395, Estudi de casos, Case studies, Malaria, wa_310, wc_750, RA1-1270, Public aspects of medicine, Embaràs, wq_256, Medicina preventiva, Sub-Saharan Africa

Classified by OpenAIRE into

mesheuropmc: parasitic diseases, health care economics and organizations
BACKGROUND: In 2012, WHO changed its recommendation for intermittent preventive treatment of malaria during pregnancy (IPTp) from two doses to monthly doses of sulfadoxine-pyrimethamine during the second and third trimesters, but noted the importance of a cost-effectiveness analysis to lend support to the decision of policy makers. We therefore estimated the incremental cost-effectiveness of IPTp with three or more (IPTp-SP3+) versus two doses of sulfadoxine-pyrimethamine (IPTp-SP2). METHODS: For this analysis, we used data from a 2013 meta-analysis of seven studies in sub-Saharan Africa. We developed a decision tree model with a lifetime horizon. We analysed the base case from a societal perspective. We did deterministic and probabilistic sensitivity analyses with appropriate parameter ranges and distributions for settings with low, moderate, and high background risk of low birthweight, and did a separate analysis for HIV-negative women. Parameters in the model were obtained for all countries included in the original meta-analysis. We did simulations in hypothetical cohorts of 1000 pregnant women receiving either IPTp-SP3+ or IPTp-SP2. We calculated disability-adjusted life-years (DALYs) for low birthweight, severe to moderate anaemia, and clinical malaria. We calculated cost estimates from data obtained in observational studies, exit surveys, and from public procurement databases. We give financial and economic costs in constant 2012 US$. The main outcome measure was the incremental cost per DALY averted. FINDINGS: The delivery of IPTp-SP3+ to 1000 pregnant women averted 113.4 DALYs at an incremental cost of $825.67 producing an incremental cost-effectiveness ratio (ICER) of $7.28 per DALY averted. The results remained robust in the deterministic sensitivity analysis. In the probabilistic sensitivity analyses, the ICER was $7.7 per DALY averted for moderate risk of low birthweight, $19.4 per DALY averted for low risk, and $4.0 per DALY averted for high risk. The ICER for HIV-negative women was $6.2 per DALY averted. INTERPRETATION: Our findings lend strong support to the WHO guidelines that recommend a monthly dose of IPTp-SP from the second trimester onwards.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1 Desai M, ter Kuile FO, Nosten F, et al. Epidemiology and burden of malaria in pregnancy. Lancet Infect Dis 2007; 7: 93-104.
    • Quantifying the number of pregnancies at risk of malaria in 2007: a demographic study. PLoS Med 2010; 7: e1000221.
    • AFR/MAL/04/01. Brazzaville: WHO Regional Office for Africa, 2004.
    • Am J Trop Med Hyg 2001; 64 (suppl 1-2): 45-56.
    • Sicuri E, Bardaji A, Nhampossa T, et al. Cost-effectiveness of intermittent preventive treatment of malaria in pregnancy in southern Mozambique. PloS One 2010; 5: e13407.
    • Wolfe EB, Parise ME, Haddix AC, et al. Cost-effectiveness of sulfadoxine-pyrimethamine for the prevention of malaria-associated low birth weight. Am J Trop Med Hyg 2001; 64: 178-86.
    • Naidoo I, Roper C. Mapping 'partially resistant', 'fully resistant', and 'super resistant' malaria. Trends Parasitol 2013; 29: 505-15.
    • int/malaria/areas/preventive_therapies/pregnancy/en/index.html (accessed Jan 18, 2014).
    • World Health Organization. WHO evidence review group meeting report: IPTp-SP. 2012. http://www.who.int/malaria/mpac/ sep2012/iptp_sp_erg_meeting_report_july2012.pdf (accessed Jan 18, 2014).
    • Kayentao K, Garner P, van Eijk AM, et al. Intermittent preventive therapy for malaria during pregnancy using 2 vs 3 or more doses of sulfadoxine-pyrimethamine and risk of low birth weight in Africa: systematic review and meta-analysis. JAMA 2013; 309: 594-604.
    • 2 3 4 5 6 7 8 9 10 12 13 14 15 16 17 18 11 Institut National de la Statistique et de la Démographie. Burkina Faso Demographic and Health Survey 2010. Institut National de la Statistique et de la Démographie. http://dhsprogram.com/Data.
    • Mali Demographic and Health Survey 2006. Direction Nationale de la Statistique et de l'Informatique, Bamako, Mali.
    • Central Statistical Office Ministry of Health. Zambia demographic and health survey 2007. http://dhsprogram.com/Data.
    • National Bureau of Statistics Nairobi. Kenya Demographic and Health Survey 2008-09. Nairobi, Kenya, National Bureau of Statistics. http://dhsprogram.com/Data.
    • National Statistical Office. Malawi demographic and health survey 2010. National Statistical Office http://dhsprogram.com/Data.
    • National Bureau of Statistics. Tanzania demographic and health survey 2010. National Bureau of Statistics. http://dhsprogram.com/Data.
    • Van Eijk AM, Hill J, Ter Kuile F. Passive case detection in the control of malaria in pregnancy in low transmission areas in Africa; a meta-analysis of observational studies of the association between fever and malaria infection. Presented Oct 11, 2011, at sixth EDCTP Forum in Addis Ababa, Ethiopia. 2011.
    • Gimnig JE, MacArthur JR, M'Bang'ombe M, et al. Severe cutaneous reactions to sulfadoxine-pyrimethamine and trimethoprimsulfamethoxazole in Blantyre District, Malawi. Am J Trop Med Hyg 2006; 74: 738-43.
    • 19 International Monetary Fund. World economic outlook database. Consumer price index by country for 2012. http://www.imf.org/ external/pubs/ft/weo/2012/02/weodata/index.aspx (accessed Sept 5, 2013).
    • 20 OANDA. Historical currency converter 2012. http://www.oanda.
    • com/currency/historical-rates/ (accessed Sept 5, 2013).
    • 21 Salomon JA, Vos T, Hogan DR, et al. Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010.
    • Lancet 2012; 380: 2129-43.
    • World Health Organisation. Global burden of disease 2004 update: disability weights for diseases and conditions. http://www.who.int/ healthinfo/global_burden_disease/GBD2004_DisabilityWeights.pdf (accessed Aug 3, 2013).
    • Nice International. Methods for Economic Evaluation Project: The Gates Reference Case, 2014. http://www.york.ac.uk/media/che/ documents/MEEP report final PDF.pdf.
    • 24 Briggs AS, Claxton K. Decision Modelling for Health Economic Evaluation. Oxford: Oxford University Press, 2006.
    • 25 Hoch JS, Briggs AH, Willan AR. Something old, something new, something borrowed, something blue: a framework for the marriage of health econometrics and cost-effectiveness analysis. Health Econ 2002; 11: 415-30.
    • 26 World Health Organization. Updated IPTp-SP policy recommendation 2012. http://www.who.int/malaria/publications/ atoz/who_iptp_sp_policy_recommendation/en/ (accessed Feb 3, 2014).
    • 27 Wang H, Dwyer-Lindgren L, Lofgren KT, et al. Age-specific and sex-specific mortality in 187 countries, 1970-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380: 2071-94.
    • 28 Price RN, Simpson JA, Nosten F, et al. Factors contributing to anemia after uncomplicated falciparum malaria. Am J Trop Med Hyg 2001; 65: 614-22.
    • 29 Marchant T, Willey B, Katz J, et al. Neonatal mortality risk associated with preterm birth in East Africa, adjusted by weight for gestational age: individual participant level meta-analysis. PLoS Med 2012; 9: e1001292.
    • 30 Brabin BJ, Hakimi M, Pelletier D. An analysis of anemia and pregnancy-related maternal mortality. J Nutr 2001; 131: 604S-14S.
    • 31 World Health Organization. Choosing Interventions that are Cost Effective (WHO-CHOICE): cost effectiveness thresholds. http://www.who.int/choice/costs/CER_thresholds/en/ (accessed Feb 3, 2014).
    • 32 van Eijk AM, Hill J, Larsen DA, et al. Coverage of intermittent preventive treatment and insecticide-treated nets for the control of malaria during pregnancy in sub-Saharan Africa: a synthesis and meta-analysis of national survey data, 2009-11. Lancet Infect Dis 2013; 13: 1029-42.
    • 33 World Health Organization. World Malaria Report 2013. http:// www.who.int/malaria/publications/world_malaria_report_2013/en/ (accessed Feb 3, 2014).
    • 34 Newman RD, Hailemariam A, Jimma D, et al. Burden of malaria during pregnancy in areas of stable and unstable transmission in Ethiopia during a nonepidemic year. J Infect Dis 2003; 187: 1765-72.
    • 35 Rijken MJ, McGready R, Boel ME, et al. Malaria in pregnancy in the Asia-Pacific region. Lancet Infect Dis 2012; 12: 75-88.
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